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Fragile - Chapter 10
Martin and Ruth were having lunch a few days later. Martin was a bit distracted, as Ruth had become a bit preachy.
"Tell me you have never suggested to a patient that he seek therapy."
Between these two, the question was, of course, rhetorical. They both worked in medicine and knew that psychology and psychiatry were, at least in his opinion, necessary evils. He didn't answer her. Instead, he remembered back to when he first met Stewart...
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The ranger was trying to convince Martin that he was okay now, that with medication he was in control.
"Stewart, if I could find the right therapist, do you think you'd go and see them?"
"Sure. Yeah. Yeah, I would."
"All right," said Martin, and they'd had another one of Stewart's great cups of coffee.
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Turned out, he HAD found the right therapist. Stewart seemed a lot less guarded these days, there had not been any village incidents with him since the bird feeders, and there was the police constable he was enamoured with.
Martin thought of Dr Marcel Milligan, whose visualisation CDs had all but eradicated his haemophobia at one time. Irritatingly, Edith had tricked him into making the appointment with Milligan before she told Martin, 'His paper on therapeutic approaches to social retardation is the best I've seen.' It was probably why he felt so negatively towards the man.
He thought about the two cases of Obsessive–compulsive disorder he'd seen since relocating to Portwenn, a young man in the Army, and the young teacher, Tricia Soames, at Louisa's school. He had specifically asked each of them, "Would you like to feel more in control of your actions?"
"So, what is the difference between you and a patient?" Ruth interrupted his thoughts. "What is your philosophy, 'Physician, heal thyself?'"
Her sarcasm knew no bounds, but he felt he should answer this time.
"Of course not, it's just…"
"Yes?"
"I don't want to appear weak. I don't want to doubt myself. It affects my diagnoses. I second-guess myself, and any error I make could only be disastrous, in so many ways."
"What ways?" asked Ruth, keeping the conversation going.
"The patient's welfare, my career…" He paused, but Ruth finished his thoughts.
"Your marriage, how James would see you... You would lose control."
He thought about Milligan...
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Martin had initially been very unhappy with the doctor's young age. He wasn't engaging with the doctor right from the start.
Then Milligan surprised him and calmly said, "Isn't being a surgeon all about being in control? The precision. Wouldn't the worst thing for a surgeon be to lose that control? I wonder if it's not the fear of losing control that's bringing about this crisis."
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That was over a year ago, and here he was right back there again.
"Look," said Ruth. She actually could tell he was mildly dissociating, but she had a few things she needed to say to him. She had to stay on track, or he'd be off, back on duty. "I know I told you not to get married for the sake of the baby, and I know you didn't. But you are still not entirely content with your lot.
"You know I blame your parents. You should have been able to grow up, fall in love, have nearly everything you dreamed of, and yet be happy with what you do have, but something is stopping you."
Martin drifted again to the time he suggested to Miss Soames that she needed help and should have already known that...
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After spotting the young teacher spinning around at her doorway, but hesitating to enter, he'd asked her, "You never wondered what's wrong with you? Never looked up your symptoms on the Internet or read about OCD?"
"There's nothing wrong with me," she had replied, emphatically.
However, later, she came around to see him in the surgery. She had likely read about her symptoms, because she told him about a few.
With a determined look, she'd said, "So, how can you help me?"
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God knew he had looked up his own symptoms, hence the PTSD checklist. He'd also started researching Cognitive Processing Therapy, and Prolonged Exposure Therapy.
He remembered suggesting the former to PC Penhale when he first came to the village.
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Martin had only just learned that the village's new police constable had agoraphobia and narcolepsy.
He told Joan, "The man's a complete cupcake… I'm going to have to speak to the district chief superintendent and have him replaced."
"What, you're going to grass him up?"
"I'm not grassing him up. The man's a public servant, and he's unfit for purpose."
In her usual wise way, Joan had twisted what he said and got him thinking.
"Yes, yes, well, you're probably right. I just wonder whether it wouldn't be kinder to treat him rather than simply report him. He has a phobia, as do many people, Marty. But some of them carry on working. No one seems to mind."
With a lesson learned, Martin had met again with the policeman.
"The question I have to ask is, can you carry on doing your job whilst undergoing treatment?"
"Absolutely."
"And you're aware of the effects of cognitive-behaviour therapy?"
"I don't know what it is."
"Right, but you're still sure that you could carry out your duties whilst in the thick of it."
"Yes."
The constable had been very earnest about wanting to be cured, and not losing his job.
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Penhale seemed a different person from those early days. Nearly symptom-free.
Ruth again tried to keep Martin in the present. "You worked with a psychiatrist before, didn't you?"
"He was a boy."
"Oh, so anyone younger than you couldn't possibly know more than you about something."
He looked at her, and sighed, annoyed.
"What was the outcome of all that?" she asked. "Were you happy with the results?"
"I felt, for a while, that my sensitivity had abated."
"What methods were utilised?"
"Visualisation CDs."
"That's all?"
"I didn't really work with him. Where is all this coming from, anyway?" Martin was finally starting to pay attention to the present and realised that his aunt had not backed off this topic since their food was served.
'Good,' thought Ruth. 'Now, he's listening.' She began talking about her real reason for today's lunch.
"Louisa and I were up at the tea room on Sunday. It was nice enough to sit outside, so lots of people walked past us. As you might expect, everyone wanted to say hello to the village's head teacher."
Martin nodded. This happened all the time.
"I noticed a common theme from many of the villagers. Some simply said, 'How's the Doc?' but many said a variation of, 'Oh, it must be nice to have a break from the Doc.' Louisa, of course, defended you every time, and said you were working, or with James, or some other."
Martin was staring at her, now. He was imagining Louisa defending him. It is exactly what she would do, to try and make any situation more pleasant. She had made excuses for people, like Alison Lane when her daughter had taken appetite suppressant pills, and also for Mr. Routledge, because she wanted to rent his cottage, but more because she took pity on the lonely old man. But defending him? How often did she have to do that? He was going to ask, when Ruth bluntly came right to the point.
"Martin, I am worried that your refusal to accept that you need therapy will negatively affect your marriage. You were very young, so I don't think you knew that my brother-in-law, Phil, suffered from depression. He avoided treatment to the point where Joan drifted into an extramarital affair. I think she did it to try and feel better about herself and her chosen life. It can be isolating on a farm. And it can get old making excuses for your husband, bad-tempered or otherwise."
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Fragile - End of Chapter 10
Credits:
Martin is remembering conversations with Stewart from Episode 1-04 "The Portwenn Effect" written by Dominic Minghella, with Marcel Milligan from 4-05 "The Departed" written by Jack Lothian, with Tricia Soames from Episode 2-05 "Always on My Mind" written by Richard Stoneman, and with Joan Norton and Joe Penhale from Episode 3-03 "City Slickers" written by Richard Stoneman.